Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Department of Maternal and Child Nursing and Public Health, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
PLoS One. 2021 Jul 19;16(7):e0254838. doi: 10.1371/journal.pone.0254838. eCollection 2021.
Cardiovascular diseases (CVD) share common and modifiable risk factors; among them, unhealthy eating, physical inactivity, alcohol intake and smoking habit. However, these factors are not observed in separate and, most often, they influence each other. Risk factors established during adolescence are highly likely to remain in adult life. The aims of the current study were to evaluate the prevalence and coexistence of risk factors for CVD, as well as to investigate individual characteristic of the adolescent and environmental factors associated with risk factors' coexistence profiles. This was a cross-sectional, national, school-based epidemiological study that estimated the prevalence of cardiovascular risk factors and metabolic syndrome in adolescents aged 12 to 17 years who attended public and private schools located in Brazilian counties with a population of more than 100 thousand. For this study, thematic blocks referring to alcohol consumption, eating habits, smoking, and physical activity were used. The grade of membership method was used to identify the coexistence of risk and protective factors for CVD among adolescents. The study analytical sample comprised 71,552 adolescents. Multilevel logistic regression was used to assess the association between factors influencing the coexistence profile of risk factors for CVD. Based on adolescent-level variables, has shown that meeting positive criterion for Common Mental Disorders and not consuming the meals provided by the school have significantly increased the likelihood of belonging to the CVD-risk profile. On the other hand, school-level variables, show that studying in private schools and living in economically favored Brazilian regions have increased adolescents' likelihood of belonging to the CVD-risk profile. These results can be used to substantiate the inclusion of food environment variables in public policies focused on preventing CVD development among Brazilian adolescents.
心血管疾病（CVD）有共同的和可改变的危险因素；其中包括不健康的饮食、缺乏身体活动、饮酒和吸烟习惯。然而，这些因素并没有被单独观察到，而且它们通常相互影响。青少年时期确立的危险因素很可能会在成年后持续存在。本研究的目的是评估 CVD 危险因素的流行率和共存情况，并研究青少年个体特征和与危险因素共存模式相关的环境因素。这是一项横断面、全国性、基于学校的流行病学研究，估计了 12 至 17 岁青少年心血管危险因素和代谢综合征的流行率，这些青少年就读于巴西人口超过 10 万的公立和私立学校。为了进行这项研究，使用了涉及饮酒、饮食习惯、吸烟和身体活动的主题模块。采用隶属度等级方法来识别青少年 CVD 风险和保护因素的共存情况。本研究的分析样本包括 71552 名青少年。多水平逻辑回归用于评估影响 CVD 危险因素共存模式的因素之间的关联。基于青少年层面的变量，结果表明，符合常见精神障碍阳性标准和不食用学校提供的膳食显著增加了属于 CVD 风险特征的可能性。另一方面，学校层面的变量表明，在私立学校学习和生活在经济条件较好的巴西地区增加了青少年属于 CVD 风险特征的可能性。这些结果可用于支持在预防巴西青少年 CVD 发展的公共政策中纳入食物环境变量。
